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Inhoud geleverd door Gastroenterology and Endoscopy. Alle podcastinhoud, inclusief afleveringen, afbeeldingen en podcastbeschrijvingen, wordt rechtstreeks geüpload en geleverd door Gastroenterology and Endoscopy of hun podcastplatformpartner. Als u denkt dat iemand uw auteursrechtelijk beschermde werk zonder uw toestemming gebruikt, kunt u het hier beschreven proces https://nl.player.fm/legal volgen.
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Squid Game is back, and so is Player 456. In the gripping Season 2 premiere, Player 456 returns with a vengeance, leading a covert manhunt for the Recruiter. Hosts Phil Yu and Kiera Please dive into Gi-hun’s transformation from victim to vigilante, the Recruiter’s twisted philosophy on fairness, and the dark experiments that continue to haunt the Squid Game. Plus, we touch on the new characters, the enduring trauma of old ones, and Phil and Kiera go head-to-head in a game of Ddakjji. Finally, our resident mortician, Lauren Bowser is back to drop more truth bombs on all things death. SPOILER ALERT! Make sure you watch Squid Game Season 2 Episode 1 before listening on. Let the new games begin! IG - @SquidGameNetflix X (f.k.a. Twitter) - @SquidGame Check out more from Phil Yu @angryasianman , Kiera Please @kieraplease and Lauren Bowser @thebitchinmortician on IG Listen to more from Netflix Podcasts . Squid Game: The Official Podcast is produced by Netflix and The Mash-Up Americans.…
AI in GI Endoscopy: Revolutionizing Diagnosis and Treatment
Manage episode 441619805 series 3591778
Inhoud geleverd door Gastroenterology and Endoscopy. Alle podcastinhoud, inclusief afleveringen, afbeeldingen en podcastbeschrijvingen, wordt rechtstreeks geüpload en geleverd door Gastroenterology and Endoscopy of hun podcastplatformpartner. Als u denkt dat iemand uw auteursrechtelijk beschermde werk zonder uw toestemming gebruikt, kunt u het hier beschreven proces https://nl.player.fm/legal volgen.
In this episode of the GI Endoscopy Update Podcast, Dr. Sarah Thompson explores the latest advancements in artificial intelligence (AI) for gastrointestinal endoscopy. Key topics include:
- Recent breakthroughs in video capsule endoscopy
- AI applications in colonoscopy and lesion characterization
- Advancements in esophageal neoplasia detection
- Benefits of AI integration in endoscopic practice
- Challenges and limitations of AI implementation
- Future prospects for AI in GI endoscopy
Key takeaways:
- AI significantly improves diagnosis accuracy and efficiency
- Challenges include over-reliance risks and technical limitations
- Future developments may include integration with EHRs and personalized medicine
Sources and Resources:
- Ding et al. (Study on AI software for small-bowel abnormalities diagnosis)
- Zhang et al. (Research on magnetically guided capsule for gastric diagnosis)
- Mori et al. (Algorithms for colonoscopy image analysis)
- Hossain et al. (Study on AI in lesion characterization)
- Everson et al. (Research on AI for esophageal neoplasia detection)
- Medtronic and Modernizing Medicine collaboration (Integration of AI with EHR systems)
24 afleveringen
Manage episode 441619805 series 3591778
Inhoud geleverd door Gastroenterology and Endoscopy. Alle podcastinhoud, inclusief afleveringen, afbeeldingen en podcastbeschrijvingen, wordt rechtstreeks geüpload en geleverd door Gastroenterology and Endoscopy of hun podcastplatformpartner. Als u denkt dat iemand uw auteursrechtelijk beschermde werk zonder uw toestemming gebruikt, kunt u het hier beschreven proces https://nl.player.fm/legal volgen.
In this episode of the GI Endoscopy Update Podcast, Dr. Sarah Thompson explores the latest advancements in artificial intelligence (AI) for gastrointestinal endoscopy. Key topics include:
- Recent breakthroughs in video capsule endoscopy
- AI applications in colonoscopy and lesion characterization
- Advancements in esophageal neoplasia detection
- Benefits of AI integration in endoscopic practice
- Challenges and limitations of AI implementation
- Future prospects for AI in GI endoscopy
Key takeaways:
- AI significantly improves diagnosis accuracy and efficiency
- Challenges include over-reliance risks and technical limitations
- Future developments may include integration with EHRs and personalized medicine
Sources and Resources:
- Ding et al. (Study on AI software for small-bowel abnormalities diagnosis)
- Zhang et al. (Research on magnetically guided capsule for gastric diagnosis)
- Mori et al. (Algorithms for colonoscopy image analysis)
- Hossain et al. (Study on AI in lesion characterization)
- Everson et al. (Research on AI for esophageal neoplasia detection)
- Medtronic and Modernizing Medicine collaboration (Integration of AI with EHR systems)
24 afleveringen
Alle afleveringen
×Join us as we delve into the revolutionary world of medical imaging, specifically focusing on two advanced endoscopy techniques: Narrow Band Imaging (NBI) and Blue Light Imaging (BLI). Discover how these image-enhanced technologies utilize specific light wavelengths to dramatically improve the visualization and diagnosis of various medical conditions. We'll explore the science behind each technique, their diverse applications across different medical fields, and how they are changing the landscape of patient care. Key Topics Discussed: Introduction to Image-Enhanced Endoscopy: Understanding how NBI and BLI enhance visualization of mucosal surfaces and blood vessels. Narrow Band Imaging (NBI): How NBI uses specific blue and green light wavelengths. The science behind hemoglobin absorption and the resulting contrast in images (brown capillaries, cyan veins). Blue Light Imaging (BLI): The blue light spectrum used in BLI. How BLI interacts with tissue to reveal hidden structures. Blue Light Cystoscopy (BLC) and Hexaminolevulinate (HAL): Explanation of this specialized application for bladder cancer detection, where HAL causes cancerous cells to glow. Applications Across Medical Fields: Gastroenterology: Detection and characterization of colorectal polyps, early gastric cancer detection (BLI-bright), diagnosis of Barrett's esophagus and inflammatory bowel disease (NBI). Urology: Highly effective bladder cancer detection with BLI and HAL, NBI's role in non-muscle invasive bladder cancer and upper urinary tract examination. Pulmonology: Visualization of the bronchial mucosa for lung cancer detection and staging using NBI. Head and Neck Surgery: NBI for assessing surgical margins after procedures like Transoral Laser Microsurgery. Advantages and Considerations of NBI and BLI: NBI's excellent contrast for mucosal surfaces and blood vessels. BLI's potential for high-resolution images (especially BLI-bright). Cost considerations: NBI often being less expensive, BLI systems potentially more costly. Variability in availability of different systems. Linked Color Imaging (LCI): A brief overview of LCI and its benefits, including brighter views and enhanced polyp visibility. Choosing Between NBI and BLI: Highlighting that the best choice depends on the specific situation and the potential benefits of combining techniques. Key Terms: Narrow Band Imaging (NBI) Blue Light Imaging (BLI) Image-Enhanced Endoscopy Mucosal Surfaces Hemoglobin Capillaries Veins Hexaminolevulinate (HAL) Blue Light Cystoscopy (BLC) Colorectal Polyps Proximal Adenomas Gastric Cancer Barrett's Esophagus Inflammatory Bowel Disease Non-Muscle Invasive Bladder Cancer Bronchial Mucosa Transoral Laser Microsurgery Linked Color Imaging (LCI) Neoplastic Lesions Takeaways: NBI and BLI are powerful tools that significantly improve the visualization of tissue during endoscopic procedures. These techniques aid in the early detection and diagnosis of various conditions, including cancers. The choice between NBI and BLI often depends on the specific clinical need, and sometimes a combination of both is ideal. Ongoing advancements in imaging technology promise even better diagnostic capabilities in the future https://www.gastroendopod.com…
H. pylori Antibiotic Resistance: A Growing Medical Crisis In this comprehensive episode, we dive deep into the growing challenge of H. pylori antibiotic resistance and its impact on global healthcare. Learn about the latest treatment approaches, resistance patterns, and future therapeutic solutions. Key Topics Covered: • Understanding H. pylori and its survival mechanisms • Global prevalence and infection rates • Antibiotic resistance patterns across regions • Treatment protocols and their effectiveness • Emerging therapeutic approaches 📊 Important Statistics: - Global infection rate: 4.4 billion people affected - Clarithromycin resistance: 15.2% (North America) vs 32.5% (Asia) - Metronidazole resistance: 26.7% (North America) vs 47.6% (Asia) - Treatment success rates: 60-90% depending on resistance patterns 💡 Key Insights: 1. Traditional triple therapy becoming less effective 2. Quadruple therapy showing promise (85-95% success rate) 3. Probiotics improving eradication rates by up to 13% 4. Molecular diagnostics revolutionizing treatment approaches 🔬 Treatment Protocols Discussed: - Triple Therapy - Quadruple Therapy - Sequential Therapy - Bismuth-based regimens 🔮 Future Developments: • Antimicrobial peptides • Nanotechnology-based delivery systems • Vaccine development • Personalized medicine approaches 📚 Additional Resources: https://gastroscholar.com/h-pylori-antibiotic-resistance-treatment-challenges/ 🎯 Target Audience: Medical professionals, healthcare practitioners, and specialists interested in gastroenterology and infectious diseases. https://www.gastroendopod.com…
The Gastroenterology & Endoscopy Podcast Episode 147: Endoscopic Management of Premalignant Lesions Quick Summary: An evidence-based overview of EMR vs ESD for premalignant lesions, including technique selection, outcomes, and complication rates. Key Points: • EMR: Preferred for lesions <15mm, 0.5-1% perforation risk • ESD: Better for lesions >20mm, 83-98% en bloc resection rate • Technique selection based on lesion size, location, and suspected invasion • Watch for delayed bleeding and stricture formation Essential Reading: 1. ASGE Guidelines on ESD https://www.asge.org/docs/default-source/guidelines/asge-guideline-on-endoscopic-submucosal-dissection 2. Cleveland Clinic EMR Protocol https://my.clevelandclinic.org/health/treatments/21148-endoscopic-mucosal-resection 3. Mayo Clinic ESD Guide https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/esophageal-endoscopic-submucosal-dissection/mac-20552628 Additional Resources: • Clinical Outcomes Study - https://www.sciencedirect.com/science/article/abs/pii/S0016510712023760 • ESD Technical Analysis - https://pmc.ncbi.nlm.nih.gov/articles/PMC3072634/ • Comparative Review - https://pmc.ncbi.nlm.nih.gov/articles/PMC5824597/ • Technical Developments - https://www.sciencedirect.com/science/article/abs/pii/S0960740422000354 https://www.gastroendopod.com…
In this episode of the GI Endoscopy Update Podcast, Dr. Sarah Thompson explores the latest advancements in artificial intelligence (AI) for gastrointestinal endoscopy. Key topics include: Recent breakthroughs in video capsule endoscopy AI applications in colonoscopy and lesion characterization Advancements in esophageal neoplasia detection Benefits of AI integration in endoscopic practice Challenges and limitations of AI implementation Future prospects for AI in GI endoscopy Key takeaways: AI significantly improves diagnosis accuracy and efficiency Challenges include over-reliance risks and technical limitations Future developments may include integration with EHRs and personalized medicine Sources and Resources: Ding et al. (Study on AI software for small-bowel abnormalities diagnosis) Zhang et al. (Research on magnetically guided capsule for gastric diagnosis) Mori et al. (Algorithms for colonoscopy image analysis) Hossain et al. (Study on AI in lesion characterization) Everson et al. (Research on AI for esophageal neoplasia detection) Medtronic and Modernizing Medicine collaboration (Integration of AI with EHR systems) https://www.gastroendopod.com…
Join us for a deep dive into the cutting-edge world of polyp reshaping in colonoscopy. In this episode of The Gastroenterology & Endoscopy Podcast, we explore how these advanced techniques are transforming colorectal cancer prevention. Key Topics: The Evolution of Polyp Management From "detect and excise" to a nuanced, multifaceted approach Balancing precision, risk minimization, and colonic function preservation Cornerstones of Effective Polyp Reshaping Advanced classification systems: Paris classification and beyond Cutting-edge imaging techniques: NBI, CLE, and pit pattern evaluation The importance of size stratification and location considerations Revolutionary Reshaping Techniques Endoscopic Mucosal Resection (EMR): Injection-assisted, cap-assisted, and underwater variants Endoscopic Submucosal Dissection (ESD): Achieving en bloc removal of large lesions Full-Thickness Resection (EFTR): Tackling lesions involving the muscularis propria The Future is Now: Emerging Technologies Artificial Intelligence in polyp detection and characterization Advanced imaging: Optical coherence tomography and molecular imaging Innovative devices: From microwave ablation to biodegradable clips Personalized Approach to Technique Selection Considering lesion-specific factors, patient profiles, and endoscopist expertise The role of multidisciplinary tumor boards in complex cases Post-Resection Care and Long-Term Success Precision histopathology and risk-stratified surveillance Managing complications with cutting-edge solutions Challenges and Future Directions Standardization of quality metrics The promise of multi-omics data integration Ethical considerations in AI implementation Why Listen: Gain insights into state-of-the-art polyp management techniques Understand how these advancements are improving patient outcomes Learn about the future of endoscopic interventions in colorectal cancer prevention Expert Insight: "Every reshaped polyp represents a potential life saved, bringing us closer to a world where colorectal cancer is no longer a leading cause of cancer-related mortality."Resources Mentioned: Paris classification system for polyp morphology Kudo's classification for pit pattern evaluation Narrow-band imaging (NBI) and confocal laser endomicroscopy (CLE) Polyp Reshaping in Colonoscopy https://www.gastroendopod.com…
Welcome to our podcast on endoscopic resection of Zenker's diverticulum. Today, we'll dive deep into this condition, its treatment, and the benefits of endoscopic approaches. Zenker's diverticulum is a rare disorder of the esophagus, primarily affecting elderly individuals between their 70s and 90s. It's more common in men and occurs in about 0.01% to 0.11% of the population, with higher rates in northern Europe, the United States, and Canada[1]. This condition involves a pouch forming in the hypopharynx, typically between the cricopharyngeus (CP) muscle and the inferior pharyngeal constrictor muscle. It's a false diverticulum, meaning it only involves the mucosa and submucosal layers, not the muscular layer[1]. The exact cause isn't fully understood, but it's believed to result from abnormal pressure during swallowing, causing a weakness in the Killian triangle - the area between the horizontal and oblique fibers of the cricopharyngeus muscle[1]. Patients typically present with a long history of dysphagia, or difficulty swallowing, which occurs in up to 98% of cases. Other common symptoms include regurgitation, halitosis, aspiration, and recurrent coughing[1]. Traditionally, Zenker's diverticulum was treated with open surgery or rigid endoscopic techniques using a laryngoscope. However, these methods require general anesthesia, tracheal intubation, and are more invasive, leading to higher complication rates and longer hospital stays[2]. In recent years, flexible endoscopic treatment has emerged as a superior option. This approach offers several advantages: 1. It's less invasive, reducing patient discomfort. 2. It requires a shorter hospital stay, typically around 2 days. 3. Patients can resume oral food intake the day after treatment. 4. It has lower complication and mortality rates compared to traditional methods[2]. Now, let's discuss the key steps for performing an endoscopic resection: 1. Use of a transparent cap: This is attached to the endoscope tip. It stabilizes the view, maintains a safe distance from the tissue, and allows for precise incisions. 2. Ensuring clear visualization: The esophageal lumen and diverticulum should be clearly visible. If visibility is difficult, a guidewire or thin tube can be placed into the stomach to maintain a clear view of the esophagus. 3. Choosing the right tools: Various devices have been examined for this procedure. A hook knife is often preferred as it allows for controlled cutting and dissection of muscle fibers. Other options include argon plasma coagulation, different types of needles, stapling devices, and endoscopic scissors[3]. 4. Performing the septotomy: This is done in stages. First, incise the mucosa, then the submucosa, and finally the muscle fibers. It's crucial to proceed slowly and steadily. The goal is to cut the cricopharyngeal muscle, which is the main objective of the treatment. 5. Safety closure: After dissecting to the base of the septum, place a closing clip at the apex of the dissection. This is the most vulnerable area for perforation. A clip with a short stem is preferred to avoid irritating the opposite wall. It's important to note that this procedure is challenging and should be performed by endoscopists with high expertise in therapeutic endoscopy. It requires special training, which can be difficult to obtain due to the rarity of the condition[2]. The benefits of endoscopic treatment are significant. Patient satisfaction is reportedly very high, with patients appreciating the non-invasive nature, short hospital stay, and high rates of dysphagia resolution. Even in cases of symptom recurrence, the procedure can usually be repeated effectively[2]. In conclusion, endoscopic resection of Zenker's diverticulum represents a https://www.gastroendopod.com…
In this in-depth episode, we dive headfirst into one of the most polarizing topics in modern gastrointestinal medicine - the heated debate between cold snare polypectomy (CSP) and hot snare polypectomy (HSP) techniques. Our host provides a comprehensive overview of these two pivotal polyp removal methods, exploring their pros, cons, and appropriate use cases. We learn about: • The fundamentals of CSP and HSP • European guideline recommendations for each technique based on polyp size • Comparative data on complete resection rates and complication profiles • Managing challenges like bleeding and tissue injury • The critical importance of polyp retrieval and histopathological analysis • Potential future advancements in endoscopic tools and techniques • Adhering to best practices and clinical guidelines Key Takeaways: - CSP shows a superior safety profile for diminutive (<5mm) and small (6-9mm) sessile polyps - HSP provides coagulation benefits for larger polyps (10-20mm) and bleeding control - Both methods demonstrate comparable resection completeness for 4-10mm polyps - HSP carries higher risks like delayed bleeding and deep thermal injury - Polyp retrieval quality is high with both techniques for accurate diagnosis - Technique choice depends on balancing polyp factors and patient needs - Ongoing research and new technologies will further refine polypectomy Whether you're a seasoned endoscopist or just getting started, this episode provides invaluable insights into optimizing polypectomy outcomes through the judicious application of CSP and HSP. Join us as we unpack this critical clinical debate. Links: Cold Snare vs Hot Snare: Polypectomy Facts https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6506415/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246601/ https://www.gastroenterologyadvisor.com/colorectal-neoplasia/cold-vs-hot-snare-polypectomy-yields-more-favorable-outcomes-for-colorectal-polyps/ https://www.gastroendopod.com…
The Couinaud classification is a vital tool in the field of hepatic surgery and diagnoses. It offers a comprehensive understanding of the functional anatomy of the liver by dividing it into eight independent segments. Unlike other classification systems, Couinaud classification focuses on the liver's functional aspects rather than its external appearance. Key Takeaways: The Couinaud classification divides the liver into eight independent functional units called segments. The classification aids in precise surgical resections and accurate diagnoses. Each liver segment has its own dual vascular inflow, biliary drainage, and lymphatic drainage. The Couinaud classification is widely accepted and used in clinical practice. It is important for healthcare professionals involved in hepatic surgery, diagnoses, and radiology to understand and apply the Couinaud classification. Couinaud's innovative approach to liver segmentation has become a cornerstone in modern hepatic surgery, guiding surgeons in planning and executing procedures with utmost accuracy. By preserving the functional integrity of individual liver segments, surgical resection can be performed with optimal outcomes, enhancing patient recovery and long-term prognosis. https://www.gastroendopod.com…
Episode Overview Discussion on the endoscopic resection of a laterally spreading tumor (LST) in the ascending colon. Examination of a flat polypoid lesion larger than 10 mm, classified as an LST. Key Steps in Resection Planning Determining the Lesion's Location: Found between two folds. Analyzing Morphology: Identified as LST-granular. Surface Analysis: Using high-definition white light and narrow-band imaging, revealing a regular, cerebroid mucosal pit pattern without ulcers or depressions (Kudo IIIL). Maintaining Visibility: Employing a "suction" mark technique to keep track of the polyp. Resection Techniques Comparison of "cold snare" and "hot snare" techniques. Preference for endoscopic resection using interventional chromoendoscopy. Interventional Chromoendoscopy Submucosal injection with a blue colorant to differentiate tissue types. The concept of using colorings to guide therapeutic interventions. Resection Process Using a snare to estimate lesion size and achieve complete entrapment. Achieving an endoscopic R0 resection by applying electrosurgical current. Links: https://www.thepracticingendoscopist.com/p/endoscopic-resection-of-lst-in-ascending-colon [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353652/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8984535/ [3] https://www.linkedin.com/posts/klaus-monkemuller_endoscopic-resection-of-lsts-precise-localization-activity-7159200748767989760-w1yU [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280838/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308134/ [6] https://www.sciencedirect.com/science/article/pii/S2468448121002034 [7] https://twitter.com/EndoCollabcom/status/1753775490068832549 [8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4414758/ [9] https://www.wjgnet.com/1948-5190/full/v14/i3/113.htm [10] https://www.elsevier.es/en-revista-ge-portuguese-journal-gastroenterology-347-articulo-large-colorectal-lesions-evaluation-management-S2341454516000107 [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132716/ [12] https://www.mayoclinic.org/medical-professionals/digestive-diseases/news/reducing-post-polypectomy-bleeding-events-in-patients-who-require-antithrombotic-agents/mac-20479873 [13] https://www.giejournal.org/article/S0016-5107(20)34187-0/fulltext [14] https://dmr.amegroups.org/article/view/8102/html [15] https://www.researchgate.net/publication/260217120_Interventional_chromoendoscopy_Specific_aspects_for_the_colon [16] https://journals.lww.com/ajg/fulltext/2017/10001/risk_factors_for_delayed_colonic_post_polypectomy.527.aspx [17] https://www.sciencedirect.com/science/article/pii/S0016510720341870 [18] https://www.giejournal.org/article/S1096-2883(11)00003-9/fulltext [19] https://karger.com/ddi/article/37/5/364/95746/Accuracy-and-Pitfalls-in-the-Assessment-of-Early [20] https://www.dovepress.com/pathological-analysis-and-endoscopic-characteristics-of-colorectal-lat-peer-reviewed-fulltext-article-CMAR [21] https://journals.lww.com/ajg/fulltext/2020/10001/s3373_endoscopic_mucosal_resection_of_a_lateral.3371.aspx [22] https://www.linkedin.com/posts/endocollab_endoscopic-resection-of-lst-in-ascending-activity-7159541656394887168-cv5C [23] https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-10-135 [24] https://www.frontiersin.org/articles/10.3389/fmed.2021.728704/full [25] https://tcr.amegroups.org/article/view/48812/html https://www.gastroendopod.com…
In this episode of the Gastroenterology and Endoscopy podcast, we explore the importance of understanding and mastering different types of polypectomy snares in the endoscopic field. Not all lesions are the same, and using just one type of snare for all scenarios is often ineffective. We discuss the advantages of snares with expansial memory and hexagonal or oval snares with double buckles. The range of polypectomy snares available is vast, and each endoscopist will discover the snare that best suits their needs through practice and personal preference. Factors to consider when selecting a snare include the lesion's size and shape, the snare's ability to retain its shape and durability, and personal comfort and proficiency. Understanding and experimenting with various polypectomy snares enhances the ability to adapt to different clinical situations and leads to improved patient care. Understanding Polypectomy Snares: A Guide for Endoscopists Polypectomy snares are critical tools in the armamentarium of an endoscopist, and it’s essential to become adept with at least two types due to the variability in lesion sizes and shapes. A single snare type cannot accommodate all scenarios. Here’s a closer look at the diversity of snares and their functionalities: Expansile Memory Snares: These snares are particularly notable. I favor using snares equipped with a robust expansile memory. This feature ensures the snare retains its shape and efficiency even after multiple uses. Hexagonal or Oval Snares with Double Buckles: Snares of this design tend to maintain an expanded state very effectively. This characteristic is valuable in ensuring consistent performance over repeated procedures. However, it’s crucial to remember — there’s a plethora of tools available. Each endoscopist will, through experience and preference, determine which snare aligns best with their practice. Let’s delve into some of the key factors to consider: Lesion Size and Shape: The dimensions and morphology of the lesion dictate the type of snare required. Snare Memory and Durability: A snare that retains its shape after multiple uses is highly beneficial. Personal Comfort and Skill: Ultimately, the choice often boils down to what the endoscopist finds most efficient and comfortable to use. In summary, while the variety of polypectomy snares may seem daunting, understanding their unique features and testing different types can greatly enhance an endoscopist’s proficiency and adaptability in managing diverse lesions. Timestamps 00:22 - Importance of Multiple Snare Types 00:44 - Advantages of Snares with Memory 00:55 - Features of Hexagonal and Oval Snares 01:05 - Factors in Snare Selection 01:37 - Conclusion and Significance of Snare Variety Keywords Gastroenterology, Endoscopy, polypectomy snares, tools, techniques endocollab.com newsletter.endocollab.com/subscribe https://www.gastroendopod.com…
In this episode, we delve into the intriguing world of Cameron lesions, a medical condition first identified in 1986. We explore what these lesions are, their causes, how they are diagnosed, and treatment options. This episode is a deep dive into the intricacies of medical diagnostics and highlights the importance of detailed observation in the field of gastroenterology. Key Points Discussed: Introduction to Cameron Lesions: Understanding what Cameron lesions are and their association with hiatal hernia. Historical Background: The discovery of Cameron lesions by Cameron and Higgins in the 1980s and their relevance in patients with a portion of the stomach above the diaphragm. Causes of Cameron Lesions: Exploring mechanical trauma, friction at the level of constriction, and other contributing factors like pressure differences during respiration and gastric acid. Prevalence and Diagnosis: Discussing the prevalence of Cameron lesions in patients with hiatal hernias and the role of esophagogastroduodenoscopy (EGD) in diagnosis. Challenges in Diagnosis: Understanding why Cameron lesions are often missed in initial EGDs and the importance of special attention during examinations. Treatment Options: The mainstay of treatment with proton-pump inhibitors (PPIs) and the necessity of iron supplementation. Conclusion: Emphasizing the significance of Cameron lesions in patients with large hiatal hernias and the need for a high index of suspicion among endoscopists. Recommended Resources: https://endocollab.com/blogs/gi-endoscopy-tips-tricks/cameron-lesions https://www.thepracticingendoscopist.com/p/cameron-lesions Timestamps: - 00:00 Introduction to Cameron Lesions - 00:12 Definition and Association with Hiatal Hernia - 00:29 Discovery and Prevalence - 01:09 Causes of Cameron Lesions - 02:01 Diagnosis and Challenges - 02:37 Treatment and Management - 02:55 Association with Iron Deficiency Anemia and GERD - 03:05 Significance and Importance of Cameron Lesions - 03:26 Conclusion Keywords: Cameron lesions, hiatal hernia, gastric mucosal folds, mechanical trauma, local ischemia, mucosal stress, ulceration, EGD, proton pump inhibitors, iron deficiency anemia, GERD, size, overlooked, high index of suspicion https://www.gastroendopod.com…
In this episode of the Gastroenterology and Endoscopy Podcast, we explore the world of water-assisted colonoscopy (WAC). WAC is a technique that uses water instead of air or gas during the insertion phase of a colonoscopy, offering numerous benefits for both endoscopists and patients. By utilizing water's natural properties, WAC can reduce pain and discomfort, straighten out the colon, and enhance visibility of the mucosal surface. This technique not only improves patient comfort but also plays a crucial role in colorectal cancer prevention by improving adenoma detection rates. Join us as we delve into the advantages of WAC over traditional methods and its potential impact in the field of gastroenterology. Quotes 00:00:46 - "Studies have shown that water assisted colonoscopies can significantly reduce the pain associated with colonoscopy." 00:03:35 - "To sum up, water is not just an alternative for colon distension in colonoscopy, it's an essential component that significantly elevates the effectiveness of the procedure." Resources Water Assisted-Colonoscopy (WAC or Hydrocolonoscopy) Do You Use CO2 and Water Immersion in Diagnostic Colonoscopies on a Daily Basis? Keywords water-assisted colonoscopy, WAC, hydrocolonoscopy, benefits, endoscopists, patients, concept, application, water, air, gas, insertion phase, colonoscopy, pain, challenging cases, colonoscope, bends, loops, straightening, angulations, gravitational effect, colonic elongation, loop formation, discomfort, sedation, water irrigation, visibility, mucosal surface, adenomas, precancerous growths, ADR, colorectal cancer prevention, air insufflation, water immersion, water exchange, duration, modified version, partial WAC, CO2, combination, tight angulations, colon elongation, cleaning, lumen, folds, polyp detection, modern colonoscopes, water jets, hybrid technique, suction, liberal use, overall quality, water, cleaning, mucosal surface, colonoscopy, debris https://www.gastroendopod.com…
In this episode of the Gastroenterology and Endoscopy podcast, we discuss a challenging case involving a pedunculated duodenal adenoma. These types of polyps present unique challenges for endoscopists, requiring meticulous planning for a successful procedure. The goal is to achieve a complete R0 resection, removing the entire lesion without leaving any microscopic remnants. We explore strategies to prevent migration of the polyp into the bowel, such as positioning the patient in a decubitus supine position or using an antimotility agent. The endoscopist and assistant must be on high alert to catch the polyp with the snare, and having a Roth's net on standby is recommended. Chapters: [00:02:16] Preventing complications. [00:04:10] Preparation is key. Resources: Endoscopic Resection of Complex Duodenal Polyps Duodenal Polyp Resources on EndoCollab Quotes: 00:02:52 - "By allowing the neoplasm to float, we reduce the chances of transmitting electrosurgical current to the base of the lesion, minimizing the risk of perforation." 00:03:06 - "And when it comes to closing the wound post-resection, clips are a must." Topics Discussed: Introduction to Pedunculated Duodenal Adenoma : Brief description of the polyp’s location and importance of meticulous planning for resection. Achieving Complete Resection (R0) : Importance of removing the entire lesion and considerations to make during resection. Preventing Polyp Migration : Strategies to prevent the polyp from moving into the distal bowel. Complication Prevention : Discussion on measures to prevent complications during and after endoscopic resection. Tools and Techniques : Exploration of various tools (snare, Roth’s net, distal transparent cap) and techniques (submucosal injection, underwater resection, use of endoloops and clips). Managing Immediate and Delayed Bleeding : Importance of using endoscopic clips and hemostatic hydrogels, especially in patients on anticoagulation. Proximity to the Papilla of Vater : Ensuring correct identification of the lesion’s location and planning the resection accordingly. Post-procedure Care : Importance of starting proton pump inhibitors post-procedure. Final Thoughts and Goodbye : Summing up the key takeaways from the episode and bidding farewell to the listeners. Keywords: Gastroenterology, Endoscopy, pedunculated duodenal adenoma, endoscopic procedures, complications,closing the wound, post-resection, clips, duodenal endoscopic resections, bleeding complications, hemostatic hydrogels, Puristat, anticoagulation, proton pump inhibitors, healing process, polyp's proximity, papilla of vater, ampullary lesion, resection, side-viewing endoscope, complete R0 resection, pedunculated duodenal adenomas, preparation, plan, outcome, patient, insightful, helpful, practice https://www.gastroendopod.com…
In this episode, we discuss the importance of improving colonoscopy prep and achieving better Boston bowel preparation scores. Colon cancer is the second leading cause of cancer death in the US, but it is preventable through colonoscopies. However, the success of a colonoscopy relies heavily on proper bowel preparation. Inadequate prep can decrease polyp detection rates by 27%. Patients are advised to follow a special diet and take a bowel cleansing solution prior to the procedure to ensure a clear view of the colon. The cleanliness of the colon is graded using the Boston Bowel Preparation Scale, with a minimum score of 6 recommended for optimal polyp detection. Unfortunately, the endoscopy center discussed in the episode noticed alarmingly low Boston prep scores among their patients. Quotes: 00:00:29 - "They allow doctors to have a clear view of the entire colon, catching precancerous polyps before they develop into cancer." 00:04:13 - "The results of these changes have been nothing short of transformative." Chapters: [00:01:45] Importance of Boston bowel preparation. [00:04:25] Thorough colonoscopy PrEP is indispensable. Read more: Improving Colonoscopy Prep and Achieving Better Boston Bowel Preparation Scores Can I have your experience with colonoscopy prep? I have noticed that most of the patients we receive don't have a good Boston score? Keywords: colonoscopy prep, Boston bowel preparation scores, colon cancer, colonoscopies, bowel preparation, nurses, split-dose bowel preparation regimen, PrEP solution https://www.gastroendopod.com…
In this episode we discuss using natural color changes called "biologic chromoendoscopy" to detect challenging flat colorectal lesions. Key Topics Discussed: - While sessile and pedunculated polyps are easy to spot endoscopically, flat and serrated lesions are challenging - AI, virtual chromoendoscopy, and dyes aren't reliable for flat lesions obscured by mucus/debris - Mucus changes light penetration, traps stool, and creates a hazy appearance - Two mucin secretion changes: lost O-acetyl groups and increased sialylation - "Chicken skin mucosa" refers to white spots from lipid-laden macrophages linked to adenomas, cancer, and juvenile polyps - Melanosis coli is dark pigmentation from lipofuscin deposits due to chronic laxative use - Recognizing subtle color changes is critical for finding precancerous flat lesions - Human eye notices what AI systems miss when looking for discolored tissue Key Quotes: - "I call the lesions' natural color changes 'biologic chromoendoscopy.'" - "Other examples are 'chicken skin mucosa' and melanosis coli." - "Recognizing these subtle color changes is critical for finding precancerous flat lesions." Links: Biologic Chromoendoscopy – The Eye Beats Artificial Intelligence References Made: - Mucin secretion changes in serrated lesions - Melanosis coli and anthraquinone laxative use - Chicken skin mucosa first described in Japan Keywords: - colorectal cancer screening - colonoscopy - endoscopy - polyp detection - flat lesions - sessile serrated lesions - biologic chromoendoscopy - natural chromoendoscopy - chicken skin mucosa - melanosis coli - mucin secretion - AI in endoscopy - virtual chromoendoscopy - chromoendoscopy techniques - lipofuscin - precancerous polyps - colorectal polyps - anthraquinone laxatives - visual characterization of lesions - hazy lesions - discolored lesions https://www.gastroendopod.com…
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